Kidney cancer treatment focuses on removing all cancer cells so that a person can retain kidney function and survive. The right treatment depends on the stage of cancer. In the early stages of cancer, the goal is to completely cure it.
Kidney cancer is highly treatable with early diagnosis and treatment. Renal cell carcinoma, which makes up
The right kidney cancer treatment, as well as the length of time it takes to work, typically depends on:
- how a person tolerates treatment — for example, whether they experience side effects
- the stage of cancer
- the person’s overall health
Read on to learn more about kidney cancer treatment, side effects, and what to expect.
Renal cell carcinoma makes up about 90% of all kidney cancers. Many renal cell cancers
A person may have one of several subtypes of renal cell cancer:
- clear cell
- oncocytoma, which is less aggressive than other forms
- collecting duct, which is a highly aggressive form
Staging of kidney cancer
Doctors divide kidney cancer into four stages. The lower the stage number, the less the cancer
- Stage 1: Cancer is localized to just the kidney.
- Stage 2: Cancer has spread to the tissues around the kidneys.
- Stage 3: Cancer has spread further to surrounding structures, such as the renal vein or lymph nodes.
- Stage 4: Cancer has spread to other organs or structures.
Early stage kidney cancer
Several treatment options exist for all stages of kidney cancer.
In stage 1, partial nephrectomy or radial nephrectomy may cure the cancer. Partial nephrectomy involves the removal of some kidney cells, while radical nephrectomy involves the removal of the whole kidney. A radial nephrectomy is a viable option for some people, as a person can live with just one kidney.
In stages 2 and 3, removal of the kidney is also the standard of care, but the chances of curing the cancer are lower.
A doctor may also recommend nephrectomy for stage 4 cancer, but this will only prolong survival, not cure the cancer.
People for whom surgery is not an option, such as those who are too frail, may opt for nonsurgical treatments. Risks associated with surgery include:
- damage to internal organs such as the spleen
- kidney failure
- leaking of urine into the abdomen
- problems with wound healing
Doctors may use ablation techniques to destroy small tumors — typically those smaller than 4 centimeters. This involves the use of probes.
Cryoablation or cryotherapy uses very cold gases that pass through a probe. An ice ball created at the probe’s tip can infiltrate the tumor and destroy it.
Alternatively, an electric current can pass through a probe and directly act on the tumor. This is called radiofrequency ablation.
Risks associated with ablation include:
- damage to tissues near the tumor
Typically, a doctor may prescribe chemotherapy alongside other therapies. This may be because the response rates of kidney cancer to chemotherapy are traditionally low and chemotherapy will not cure the cancer.
Radiation therapy, which uses high energy particles to kill cancer cells,
Radiation does not typically cure the cancer but may help shrink tumors in some people.
A number of
Doctors usually recommend targeted therapies to people with advanced cancer or those who cannot have surgery.
Each therapy works slightly differently. For example, certain drugs act on endothelial growth factor (VEGF) and VEGF receptor VEGFR to reduce tumors’ ability to grow. Some drugs that work in this way are:
- sunitinib (Sutent)
- sorafenib (Nexavar)
- bevacizumab (Avastin)
- axitinib (Inlyta)
- pazopanib (Votrient)
The side effects that people may experience depend on the specific drug they are taking.
Doctors usually recommend these therapies to people with late stage cancers or those whose cancer is not curable.
While these drugs may prolong survival, long-term survival rates are low.
Similar to targeted therapies, immunotherapy aims to support the immune system to defend the body against cancer. This treatment typically involves inhibitor drugs, which can shrink tumors or slow their growth.
Immunotherapy prolongs survival but does not cure the cancer.
Doctors may choose to monitor people with small tumors or masses that are benign. Nearly 3 out of 4 small kidney cancer are slow-growing.
Healthcare professionals can perform imaging tests every 3–6 months to check whether tumors are growing. These tests may include:
- CT scans
This is a good option for people who are older or frail.
Advanced kidney cancer carries a high death rate and is not usually possible to cure. Instead, treatment focuses on prolonging survival and reducing pain.
In addition to the options mentioned previously, treatment options include:
- targeted cancer drugs
- participation in a clinical trial
- palliative care to ease pain
- hospice care to stop treatment and reduce pain as death approaches
- a combination of therapies
Kidney cancer may recur. This means that it can come back after treatment.
Doctors usually recommend ongoing monitoring to catch recurrent kidney cancer in its early stages.
Other factors include:
- Cancer genetics: The genetics of the cancer may determine which targeted therapies are likely to work best.
- Age and health: Older people and people in poor health may not be able to have surgery.
- Type of kidney cancer: Certain types of kidney cancer are more aggressive and more likely to spread than others. Medullary renal cell carcinoma,
for example, is highly aggressive and may occur in people with sickle cell disease.
- Treatment goals and preferences: Some people, especially those who are not in good health or who have more advanced cancer, may prefer to avoid the side effects of treatment and instead pursue palliative options.
According to the
- Overall: 76%
- Localized cancer in just the kidney: 93%
- Regional cancer: 71%
- Distant/metastatic cancer: 14%
As a result of new and emerging treatments, survival rates are improving. Therefore, a person who receives a diagnosis today may have a higher likelihood of long-term survival than these figures indicate.
A person with kidney cancer should find an oncologist who specializes in renal cancer.
Large teaching hospitals often have specific programs. People should ask clear, specific questions about prognosis, treatment options, and clinical trials before choosing an oncologist. People can find additional support through the following organizations:
Early stage kidney cancer has a better prognosis than many other cancers. For this reason, seeking prompt treatment may save a person’s life. However, even in cases of advanced cancer, a cure may be possible with successful surgery.
People with kidney cancer should seek care from an oncologist who has experience with kidney cancer. Large teaching hospitals and cancer care centers often offer innovative care, as well as access to clinical trials, lifestyle support, and palliative care.